The government's tragic argument against opposition to NHS plans

Wed 7th Mar 2012

The prognosis is not good.

If I were Andrew Lansley’s medical practitioner, I would have to lean in gently, place a firm hand on his wrist and begin the next sentence with the words “I’m sorry”...

Instead of bursting into tears and raising his hands to the sky asking “why me?”, he would simply get up out of his seat and walk out of the surgery with a smile on his face, promising that he would go do the right thing.

When it comes to the Health Minister’s plans for the National Health Service, the patients are against it, the nurses are against it, the doctors are against it. Even the government are against it. Well, sort of – there’s a few Liberal Democrats looking a bit whey-faced in the corridors of the Houses of Parliament. Admittedly, this is not an irregular occurrence, as a glimpse at an opinion poll is enough to drain most Lib Dems of colour in their face. But they realise that they may have stepped over the line when it comes to backing the Tories over this bill.

Some have even taken to calling him 'Voldemort Lansley', which is a bit harsh. On Voldemort.

He repeatedly says that he wishes to inject competition into the NHS. Obviously keeping patients alive is not a big enough challenge – they need a massive sports day or something.

There is a history of bungling when it comes to our health service. Back in 2000, announcing the ‘NHS Plan’, the Department of Health’s own website’s first words on the matter were: “The NHS Plan outlines the vision of a health service designed around the patient”, which I suppose is better than it being designed around African elephants.

New strategies are often trumpeted as essential to repair our creaking hospitals and creakier doctors. Every few years a government body will announce new guidelines, which always promise better service but rarely deliver. When it comes to a patient in Accident & Emergency having an urgent transfusion, successive Ministers appear to be under the illusion that what is needed is more bureaucracy.

Last year, when momentum was gathering against the changes, the coalition announced it was to partake in a “listening exercise”, which makes it sound like David Cameron and Lansley are going to stand further apart from each other, shouting “Can you hear me now?”

Perhaps the most cynical aspect of the new measures is the stripping of the National Institute for Clinical Excellence’s powers. NICE have the grubby job of deciding which treatments the NHS can and can't afford. Sometimes a drug is refused because it is too costly and does not provide value for money. They even have a mechanism where they work out how much it costs to keep a patient alive per year and acceptable drugs must be within a certain limit. Campaigners argue that you cannot put a price on people’s well-being but if this were the case, I’d be asking for a Malibu beach house on prescription.

It is both horrible and necessary work. If NICE weren’t there, we could be taken for a ride by the big pharmaceutical companies. It offers a gold standard for clinical medication and manufacturers know they must meet the guidelines or else be denied a license to sell via the NHS, hence meaning that standards improve. Without a professional yardstick to measure outcomes against, I could take a handful of jelly beans to my local health consortium and convince them that I held in my hands a life-saving wonder drug.

Another key aspect of the reforms is that GPs are going to be given powers to purchase healthcare for their patients, putting them in charge of health service budgets. Many GPs do not want this role and it is easy to see why; they can barely organise their waiting room sufficiently, so who knows how they will cope if their workplace is transformed into a free-market utopia? When money is being removed and workers are being cut from the NHS, it seems a little unsettling that the people being put in charge of your treatment also have to watch the pennies.

When the changes come into effect, you’ll be hoping that the person ahead of you in the queue has a quick and cheap problem. If a stooped man with a hacking cough, a limp, a patch over one eye, and a knife handle sticking out of his shoulder is called to see the doctor first, you’ll fear the worst.

Much opposition to the plans, according to the government, stems from the fact that people don’t understand the bill well enough. Anna Soubry MP of the Health Department said “I will concede that we probably have not explained it in the simple plain terms it should be explained in”. It is quite obvious why: there are no simple terms to explain it in. What a tragic argument. You know someone has lost an argument when they say it’s because they haven’t explained it well enough. Communication is not the issue here.